Nokea
A patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed a metered-dose inhaler (MDI) with a spacer. Which instruction should the nurse include in the demonstration of MDI use?
- A. Inhale slowly and deeply while pressing the canister.
- B. Exhale completely before inhaling the medication.
- C. Shake the inhaler vigorously before each puff.
- D. Hold the breath for 10 seconds after inhaling the medication.
Correct Answer: A
Rationale: The correct instruction for using a metered-dose inhaler (MDI) with a spacer for a patient with COPD is to inhale slowly and deeply while pressing the canister. This technique helps ensure that the medication reaches the lungs effectively. Inhaling slowly and deeply allows the medication to be properly delivered to the airways, maximizing its effectiveness in treating the symptoms of COPD. This instruction helps the patient coordinate pressing the canister with their inhalation, which is crucial for proper medication delivery in COPD management.
You may also like to solve these questions
It is 10 o'clock of your watch. The client asks, "What time is it?" The nurse's appropriate response is:
- A. "Are you bored?"
- B. "It is 10 o'clock.".
- C. "Why do you ask?"
- D. "Guess, what time is it?"
Correct Answer: B
Rationale: The nurse's appropriate response is to provide the requested information clearly and directly. In this case, the client asked for the time, so the best response is to say "It is 10 o'clock" to answer their question promptly. Options A, C, and D do not address the client's question and may be perceived as dismissive or unhelpful.
A patient is prescribed an angiotensin-converting enzyme (ACE) inhibitor for heart failure. Which laboratory parameter should the nurse monitor closely during ACE inhibitor therapy?
- A. Serum potassium levels
- B. Serum sodium levels
- C. Blood glucose levels
- D. Serum creatinine levels
Correct Answer: A
Rationale: The nurse should monitor serum potassium levels closely during ACE inhibitor therapy because ACE inhibitors can lead to an increase in serum potassium levels, known as hyperkalemia. ACE inhibitors block the conversion of angiotensin I to angiotensin II, which in turn decreases aldosterone secretion. Aldosterone normally acts in the kidneys to reabsorb sodium and water and excrete potassium. Therefore, when aldosterone secretion is decreased due to ACE inhibitor therapy, there can be an increase in potassium retention, potentially leading to hyperkalemia. Monitoring serum potassium levels is essential to prevent complications associated with hyperkalemia, such as cardiac arrhythmias.
When the patient turned 69 years old, Orinase was discontinued and NPH insulin is prescribed for her. After several months, she is determined to be suffering from sumogyi effect. Which of the following conditons will most likely result when the patient is receiving too much insulin?
- A. Developing an elevation of the blood glucose level
- B. Producing even more insulin
- C. Becoming resistant to insulin
- D. Conserving excessive amount of fluid
Correct Answer: A
Rationale: When a patient is receiving too much insulin, the most likely result is hypoglycemia, not hyperglycemia. The excess insulin causes the blood glucose level to drop too low, leading to symptoms such as sweating, tremors, confusion, and in severe cases, seizures. The body responds to hypoglycemia by releasing counterregulatory hormones such as glucagon, epinephrine, and cortisol, which work to increase the blood glucose level. This rebound effect, known as the Somogyi effect, can result in the patient experiencing high blood glucose levels after a period of insufficient glucose supply due to excessive insulin administration.
"Commitment to continual learning and active participation in the development and growth of the profession are commendable obligations" is contained in which of the following?
- A. Code of Ethics
- B. RA 7164
- C. RA 10912
- D. RA 9173
Correct Answer: A
Rationale: The statement "Commitment to continual learning and active participation in the development and growth of the profession are commendable obligations" is typically found in a profession's Code of Ethics rather than specific laws or regulations like RA 7164, RA 10912, or RA 9173. Codes of Ethics serve as guidelines for professionals to uphold ethical standards and behavior within their respective fields. These codes often emphasize the importance of ongoing learning and professional development to ensure that practitioners stay current and competent in their practice. Therefore, the statement is most likely to be part of a Code of Ethics that guides professionals in their conduct and responsibilities.
A woman in active labor presents with a prolonged latent phase, characterized by irregular and ineffective contractions. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?
- A. Maternal hypotension
- B. Maternal anxiety
- C. Fetal macrosomia
- D. Maternal fever
Correct Answer: B
Rationale: Maternal anxiety can contribute to a prolonged latent phase during labor. Stress and anxiety can trigger the release of stress hormones such as adrenaline, which can interfere with the production of oxytocin, the hormone responsible for initiating contractions. This can result in irregular and ineffective contractions, leading to a prolonged latent phase. It is important for the nurse to assess the woman's anxiety levels and provide reassurance and support to help facilitate the progression of labor.